4. The Health Insurance Portability and Accountability Act (HIPAA) What is HIPAA? Who is Affected by HIPAA? What is Protected Health Information (PHI)? What are the Seven Patients Rights regarding privacy of PHI (Protected Health Information)? What are the benefits of HIPAA? What does HIPAA mean for patients? What does HIPAA mean for staff?
5. HIPAA - What is it? The Health Insurance Portability & Accountability Act of 1996 (HIPAA), Public Law was passed by Congress: To improve portability and continuity of health insurance coverage in the group and individual markets To combat waste, fraud, and abuse in health insurance and health care delivery To reduce costs and the administrative burdens of health care by improving efficiency and effectiveness of the health care system by standardizing the interchange of electronic data for specified administrative and financial transactions To ensure protecting the privacy of Americans’ personal health records by protecting the security and confidentiality of health care information
6. Who is Affected? Employees who handle/use/know individuals’ Protected Health Information (PHI) Health Care Providers (Health departments, hospitals, doctors’ offices, any agency that transmits PHI electronically) Health Plans that provide or pay the cost of medical care (e.g. Medicaid, Medicare, Champus, BC/BS, HMO’s)
7. Protected Health Information (PHI) Any information about health status, provision of health care, or payment for health care that can be linked to a specific individual.
8. What are the Seven Patients Rights Regarding Privacy of PHI (Protected Health Information) Individuals have the right to: Receive notice of an agency’s privacy practices. Know that an agency will use its PHI ONLY for treatment, payment, operations (TPO), certain other permitted uses and uses as required by law Consent to and control the use and disclosure of their PHI.
9. Seven Rights…..Continued Accesstheir protected health information (PHI), except for psychotherapy notes (they might be charged for copies) Request amendment or addendum to their PHI (not always granted) Receive accountings of disclosures File privacy complaints to agency officer
10. What are the benefits of HIPAA? Reduces the administrative burden and cost for providers and payers Standardizes many of the administrative tasks in the health care Simplifies the exchange of information and reduces paperwork Patients will have more rights over their own health information
11. What does HIPAA mean for patients? Ensure patient confidentiality is maintained through secure networks and ensure employees have authorized access to patient information. Patients permission must be received in advance before releasing any protected health information (PHI) for any reason other than treatment, payment, and health care operations.
12. What does HIPAA mean for staff? Staff must make sure desktop computer is secure when not using it or when they step away for any reason Staff will only have access to a patient’s Protected Health Information (PHI) on a “need to know” basis (minimum necessary provision under the Privacy Rule) Patient’s information cannot be discussed with anyone who does not have a need to know
13. Key Things to Remember We must safeguard consumer records Share only information necessary to do the work Consumers have a right to ask about use and disclosure of PHI